Evidence map›Paper›PMID 40287362›Full record

SynthesisBritish journal of anaesthesia2025

Efficacy of enhanced recovery programmes for cardiac surgery: a systematic review and meta-analysis.

Danny F Hoogma, Immele Meeusen, Steve Coppens, Peter Verbrugghe, Jef van den Eynde, Daniel T Engelman, Michael C Grant, Christian Stoppe, Steffen Rex

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Danny F HoogmaDepartment of Anesthesiology, University Hospitals Leuven, KU Leuven, Leuven, Belgium; Biomedical Sciences Group, Department of Cardiovascular Sciences, University of Leuven, KU Leuven, Leuven, Belgium. Electronic address: Danny.hoogma@uzleuven.be.
Immele MeeusenBiomedical Sciences, University of Leuven, KU Leuven, Leuven, Belgium.
Steve CoppensDepartment of Anesthesiology, University Hospitals Leuven, KU Leuven, Leuven, Belgium; Biomedical Sciences Group, Department of Cardiovascular Sciences, University of Leuven, KU Leuven, Leuven, Belgium.
Peter VerbruggheBiomedical Sciences Group, Department of Cardiovascular Sciences, University of Leuven, KU Leuven, Leuven, Belgium; Department of Cardiac Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
Jef van den EyndeBiomedical Sciences Group, Department of Cardiovascular Sciences, University of Leuven, KU Leuven, Leuven, Belgium.
Daniel T EngelmanHeart and Vascular Program, Baystate Medical Center, Springfield, MA, USA.
Michael C GrantDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christian StoppeDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Charité Berlin, Berlin, Germany.
Steffen RexDepartment of Anesthesiology, University Hospitals Leuven, KU Leuven, Leuven, Belgium; Biomedical Sciences Group, Department of Cardiovascular Sciences, University of Leuven, KU Leuven, Leuven, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe terms fast-track (FT) and enhanced recovery after surgery (ERAS) are often mistakenly used interchangeably. Fast-track cardiac anaesthesia focuses on perioperative strategies, whereas ERAS (or enhanced recovery programme [ERP]) encompasses a wider range of strategies designed to enhance overall recovery. Evidence is needed to demonstrate the additive value of ERP above FT in cardiac surgery. We conducted a meta-analysis to investigate the comparative efficacy of ERP and FT programmes in cardiac surgery.

methodsWe systematically searched PubMed, Embase, and Web of Science for randomised trials and prospective observational trials investigating ERP or FT programmes in cardiac surgery (up to November 16, 2024). Following PRISMA guidelines, two reviewers independently selected studies, extracted data, and assessed risk of bias. Data were pooled using a random-effects model. The primary efficacy outcome was hospital length of stay (LOS).

resultsA total of 6368 articles were identified, of which 18 studies, with 2625 patients, were included. Compared with control, a significant reduction in hospital LOS (mean difference [95% confidence interval (CI)] -1.40 days [-2.19 to -0.61], P=0.001), ICU LOS (-13.22 h [-21.75 to -4.68], P=0.006), and ventilation time (-4.68 h [-7.85 to -1.52], P=0.008) was identified when ERP or FT programmes were implemented. ERP demonstrated an additive value above FT for hospital LOS (2.11 days [-3.52 to 0.71] vs -0.30 days [-0.88 to 0.27], respectively; P=0.003).

conclusionsIn cardiac surgery, ERP can reduce LOS in the ICU and hospital and ventilatory time. Moreover, it is suggested that ERPs, including preoperative, intraoperative, and postoperative interventions, are preferred above only intraoperative FT strategies. SYSTEMATIC REVIEW PROTOCOL: PROSPERO (CRD42022382409).

Indexed as

Cardiac Surgical ProceduresEnhanced Recovery After SurgeryPerioperative CareHumansLength of StayRandomized Controlled Trials as Topiccardiac anaesthesiacardiac surgeryenhanced recoveryERASERPfast-trackrecovery programme

Identifiers

PMID40287362
PMCPMC12597454

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.